At the Crohn’s and Colitis Congress, an 8-week study was presented showing promising results in using low doses of IL-2 in treating moderate to severe UC. IL-2 or, aldesleukin, is a drug commonly used for melanoma (skin cancer) and RCC, a type of cancer that starts in the kidneys. The medicine works by targeting specific regulatory T cells called Tregs. These Tregs are more sensitive to IL-2 because of the receptors they have. By bulking up these T cells through proteins called cytokines, it helps the body target the cancer.
Since being successful in cancer treatment, more research is being done about its role in helping other autoimmune diseases including UC. This was proposed because we know that regulatory T cells promote intestinal health and are linked to autoimmunity. Scientists have also found that those with IBD can be defiant in these T cells in particular. The hope being, that if there are more regulatory T cells, maybe they can control gut health and calm down the improper immune response.
This eight-week study involved 26 adults with Ulcerative colitis. The collective group had Mayo scores ranging from 6-12, and had also previously failed at least one type of biologic treatment, although the majority had failed two. This group was divided into three groups who all received the medication, but at different doses. Group A at 0.3 x 10⁶ IU, Group B at 1 x 10⁶ IU, and Group C at 1.5 x 10⁶ IU. The medication was administered via subcutaneous injection daily. Clinical and laboratory assessments were conducted every week.
Of the four in Group A, one achieved clinical remission, although two of the four showed increased Treg expression. All together seventeen people were in Group B and 53% showed clinical response, with 23% in complete remission. The remaining Group C had more side effects than the other groups, and while they all showed increased Treg expression, none saw clinical response or remission. This led the researchers to conclude that 1 x 10⁶ IU is the maximum effective dose for UC patients in particular.
Seeing a 53% clinical response is a strong start. This drug class will probably find itself in proper human trials for those with UC within the next few years. There are already other ‘chemo’ type medications approved to be prescribed to UC patients including Imuran (azathioprine). While Imuran and IL-2 work a bit differently, it would offer an additional medication option for those who have already failed others. The more advancements in research and scientific discovery there are in the field of autoimmunity, the closer we get to curing Crohn’s and Colitis.
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